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T-Cell Large Granular Lymphocytic Leukemia of Donor Origin Occurring After Allogeneic Bone Marrow Transplantation for B-Cell Lymphoproliferative Disorders

Hong Chang MD, PhD, FRCPC, Suzanne Kamel-Reid PhD, Nusrat Hussain MD, Jeff Lipton MD, PhD, FRCPC, Hans A. Messner MD, PhD, FRCPC
DOI: http://dx.doi.org/10.1309/GLH5NVCFB9BKMV9G 196-199 First published online: 1 February 2005

Abstract

T-cell lymphoproliferative disorders are uncommon occurrences after bone marrow transplantation (BMT). We describe 2 patients in whom a monoclonal T-cell large granular lymphocytosis (T-LGL) developed after allogeneic BMT for B-cell lymphoproliferative disorders. Both patients showed a persistent expansion of CD3+, CD8+, and CD57+ large granular lymphocytes of donor origin with clonally rearranged T-cell receptor γ genes and no evidence of Epstein-Barr virus–related infection. The manifestations were consistent with T-LGL leukemia as defined by the World Health Organization criteria. In both patients, graft-vs-host disease developed, and 1 had recurrent episodes of cytomegalovirus viremia. The other patient had received a graft from a hepatitis C antibody–positive donor without developing any signs of hepatitis C infection. Both patients remain in complete remission from their B-cell lymphoproliferative disorders and do not have symptoms related to T-LGL leukemia. These data show that T-LGL leukemia should be included as one of the types of posttransplantation lymphoproliferative disorders that can occur after allogeneic BMT for B-cell neoplasms.

Key Words:
  • T-cell large granular lymphocyte leukemia
  • Bone marrow transplantation
  • B-cell lymphoproliferative disorder
  • Donor cell origin